The adverse effect of hydrosalpinges on in vitro fertilization pregnancy rates and the benefit of surgical correction.
OBJECTIVE
To test the hypothesis that IVF-ET pregnancy rates (PRs) for patients with tubal factor infertility are decreased in patients with hydrosalpinges and that surgical correction reverses this effect.


METHODS
Retrospective chart review.


METHODS
Private practice IVF-ET program.


METHODS
Patients (n = 160) undergoing 238 cycles of IVF-ET were stratified into groups based on the presence of hydrosalpinges and whether surgical correction had been performed. Patients >39 years old and patients with male factor infertility were excluded from the study.


METHODS
Patients with hydrosalpinges were offered surgical correction.


METHODS
Clinical pregnancy defined by an intrauterine gestational sac.


RESULTS
Patients with hydrosalpinges had significantly decreased implantation rates and PRs per transfer (2.8% and 8.5%, respectively) than patients with tubal factor infertility but without hydrosalpinges (15.7% and 38.6%). Surgical correction improved implantation rates and PRs in patients with prior failed cycles (16.1% and 37.5%) and in patients undergoing surgery before IVF-ET (21.8% and 51.7%). The type of surgery performed did not affect success rates in the small number of patients evaluated.


CONCLUSIONS
The presence of a hydrosalpinx during an IVF-ET cycle results in significant decreases in implantation rates and PRs. Surgical treatment of hydrosalpinges before IVF-ET cycles improves implantation rates and PRs.
Murray
D L
DL
The Shady Grove Fertility Center, Rockville, Maryland 20850, USA.
Sagoskin
A W
AW
Widra
E A
EA
Levy
M J
MJ
D000328:Adult; D010064:Embryo Implantation; D005184:Fallopian Tube Diseases / Q000150:complications / Q000503:physiopathology* / Q000601:surgery*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007247:Infertility, Female / Q000209:etiology; D008297:Male; D008499:Medical Records; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D012489:Salpingostomy